The Third Annual Montefiore-Einstein Preventive Cardiology Conference.

You can easily get your own report on the conference by searching #MEPCC19 on Twitter.

  There was once again a stellar group of presenters there, starting with Dr. Ostfeld himself, who opened the conference, followed by

• Dr. Caldwell Esselstyn, Jr. on his favorite topic: why Heart disease is a paper tiger that need not exist, and if it does can be reversed with diet. I never get tired of hearing him and I had a chance to speak with him briefly.
• Dr. Philip Gordts, on a fascinating (relatively) new evolutionary theory on why red meat is such a trigger for heart disease in humans. Understanding the "why" is always helpful. See also this newspaper article Red meat triggers toxic immune reaction which causes cancer, scientists find. Bottom line: we always knew from the research of Dr. Colin Campbell that animal proteins tend to stimulate tumor growth and now this mechanism that Dr. Gordts discussed may be the evolutionary reason why our bodies reject meat - it contains a sugar which occurs in many mammals, but not humans, called Neu5Gc and the body rejects it and treats it as a foreign invader.
• Dr. Walter Willett, on achieving an optimal diet.
• Dr. Wilson Tang, on Diet, Intestinal Biota and Cardio-renal Disease Risk. This area is ever so important. The first shocker always is that it takes only three days on a #WFPB diet for your gut to stop making TMAO, which is a leading cause of CVD.
• Dr. Andrew Freeman on why 2019 is the year of the Plant-based diets.
• Dr. Michelle McMacken, who runs the Lifestyle Medicine program at Bellevue gave the Daniel and Michael Ostfeld Memorial Lecture
• Dr. Ostfeld himself presenting on the practical issues in implementing the diet in your clinical practice (Answer: leverage outsourced support mechanisms as much as possible).
• Then a series of presentations by interns who are active in the Lifestyle Medicine field, which was brilliant. Speakers were Drs. Danielle Belardo, on a Cardiac case, Sasha deJesus, again on Cardiac issues, Clark Yarber, on an outlier case of Cardiac Syndrome X, and Timothy A. Zaki on Type 2 Diabetes.

All followed by a panel discussion of questions from the public.

There's too much information that comes out of an event like this, but here are a few highlights that stood out for me:

• Esselstyn: Focusing on the green leafies for the nitrates that convert to nitric oxide in the body, which keeps your arteries limber, combined with the high ORAC value of various fruits, particularly berries, for that is what repairs cell damage. Those are just two simple concepts that makes the whole logic of the whole foods, plant-based diet understandable.
  Complete reversals, even without statins, are typically possible in three to four weeks, but certainly within 3 months. Angina usually is much reduced within 1-2 weeks. His conclusion was that he "... felt more excited about medicine today, 20 years after retiring as a surgeon," because of the increasing uptake of these new ideas in the medical field. A comment from Dr. Joel Kahn emphasized again that stents or bypass surgery only correct for the effects of heart disease, but do not heal the disease itself - only diet will.
• Dr. Walter Willett commented on the general fact that 5-10 years life extension is a reasonable expectation from changing to a whole foods, plant-based diet. He focused on the big picture of planetary health and the EAT/Lancet study. He cautioned against becoming overly simplistic about lowering medical costs, as people will live longer. So they might spend less on medical services per year, but live more years. Time will tell.
• Dr. Wilson Tang took us through the whole TMAO issue and how choline is converted to TMA by the enzymes in the intestinal tract and subsequently oxidized in the liver to result in TMAO. It is a big cause of inflammation and implicated in heart disease (CVD/CAD), type 2 diabetes (T2D), and chronic kidney disease (CKD). Evidently, the point is that a plant-based diet will stop this immediately.
• Dr. Walter Willett's take away points were that even the Economist labeled 2019 the year of the vegan and the fact that Medicare and most major insurers now cover either the Dean Ornish program or the Pritikin protocol for reversing heart disease. Equally obvious, it is still cheaper to change to a #WFPB diet now, rather than wait until you have heart disease.
• Dr. Michelle McMacken injected a dose of reality with a beautiful case history of a 42-year-old with undiagnosed T2D and an A1C at 12.7%, who was no longer a diabetic after 4 months (A1C below 6) after throwing out his metformin at 2 months in. She also cautioned that "unhealthy vegan" is as bad or worse as the SAD.

Here is a summary on YouTube by Dr. Joel Kahn.

The whole thing was brilliant as always and an enormous asset of our community in the Bronx. Meanwhile, once again no one from the Bronx officialdom was present, but Eric Adams' office was represented, even if he could not make it. Otherwise, people came from all over. At lunch, I talked with a lovely doctor from Montgomery, Al.

Inspiration at Neerob on Nutrition and Health

The other day (10/9/18) we had a Dinner for Doctors at Neerob Restaurant with a mixed group of doctors, medical organizations, other medical professionals and general audience.

Neerob put on one spectacular plant-based dinner with a choice of four different salads, followed by a main dish of rice and two vegetable dishes and a sauce based on lentils, which is always delicious. In other words, it was a world-class plant-based dinner and a marvellous display of the flexibility and experience of Neerob Restaurant.

Chef (dark blue shirt) and Khokon, the owner (light blue shirt)

There was a lot of information distributed, on the American College of Lifestyle Physicians, which provides a way for doctors to get certified in this new specialty which revolves around prevention above all and lifestyle choices as the means, including diet, exercise, rest, relaxation, and so on.

I provided some information on Plant Pure Communities, the not for profit support group for the whole foods, plant-based diet of which I am the Group Leader for the Bronx. Our Facebook group is:
https://www.facebook.com/groups/PPCDaBronxPod/

We also provided some brief information on the 2nd Annual Montefiore Preventive Cardiology Conference, which took place the Saturday before, 10/6. After that, we proceeded with the speakers, starting with the keynote speaker for the evening, Dr. Sharon Wasserstrom, who is the first ACLM certified doctor in the Bronx, and she practices at the Montefiore clinic at 2300 Westchester Avenue... but she is going to move to Florida at the end of the year.

Dr. Sharon Wasserstrom

Dr. Wasserstrom gave a very insightful short introduction about the whole foods plant-based diet and its role in medicine, starting from the point of view that medicine became the victime of its own success based on the tremendous progress in modern times in the treatment of infectious disease, but then tried to deal with chronic illness in the same vein. However, most of the chronic diseases we are struggling with, high bloodpressure, diabetes, heart disease, cancer, on and on are primarily the result of diet, and diet should be the first means of addressing them and this is where the whole foods, plant-based diet comes in as the optimal human nutrition.
Dr. Wasserstrom presented three case histories for a Bangladeshi, a black person and a white patient, including the ups and downs, depending on how well the patients followed the diet. The results are very quick, so with a little reinforcement, people are usually motivated to continue. In most cases, it works better than medication and it has no side effects, and in the short term a physician can always assist with medication, although the levels of prescriptions may have to be adjusted quickly.

Moh. Islam on the right

Then we had some testimonials, first from Moh. Islam, a Bangladeshi nurse from Elmhurst Hospital who had a bad heart problem (95% blockage of one coronary artery), at age 36 and had a stent put in, but after trying several cardiologists he ended up working with Dr. Robert Ostfeld at the Montefiore Cardiac Wellness Program. His words were from the heart, and he explained how the genetic makeup of Southeast Asians pre-disposes them to heart disease, because their arteries are typically narrower than Westerners, so they block up easier. Another Bangladeshi person in the room chimed in that he had a heart attack at age 36. Mr. Islam ended with a powerful appeal to his Bangladeshi brothers to take care of business, starting with a Whole Foods, Plant-Based diet.

After Mr. Islam, Father David Powers of St. Helena's shared some of his experience with a fair dose of self-deprecating humor. In a different way his story is also impressive, having lost about 100 lbs since he started on the diet and feeling better.

Lastly, Angela Vita, the retail dietitian from the ShopRite at Bruckner Commons gave us a run down on shopping for a whole foods, plant-based diet at ShopRite, complete with a flyer that provides a directory to the store. Also, she announced an upcoming cooking demonstration at the store, in collaboration of CB#9 with Plant Pure Communities on 10/27 at noon.

As a general announcement, we also shared that on 10/20 we have a new Plant-Based cooking class at St. Helena's.

It was clear that sparks of inspiration were flying, and we are planning a new "dinner for doctors" to follow-up on this one in the spring, hopefully coinciding with Neerob obtaining a certification of (part of) their menu from Plant Pure Communities and from Plantricious as well.

Learn How to Heal Yourself Event in the Bronx

Phenomenal Event last night with Bronx City Councilman Fernando Cabrera, Brooklyn Borough President Eric Adams and Dr. Robert Ostfeld as keynote speaker. The occasion was the introduction of the #banthebaloney bill in the City Council and the introduction of meatless Mondays in the Bronx. The background was the presentation of the Whole Foods, Plant-Based diet as the alternative.

Brooklyn Borough President Eric Adams told the story of his own complete healing from a disastrous diabetes diagnosis with complications, and subsequently the complete healing from diabetes of his 80-year old mother, who had been an active diabetic for 40 years.

The story of city Councilman Fernando Cabrera was almost more powerful than that, for when he was hospitalized, he was given 24 hours to live and he recovered completely with the whole foods, plant-based diet.

Both recognize the issue that school lunches establish bad habits for life and are introducing the #banthebaloney bill in the NY City Council to get processed meats out of school lunches, as they are no classified by the World Health Organization as a class 1 carcinogen, along with plutonium, tobacco and asbestos.

 Dr. Robert Ostfeld discussed the full range of health conditions that are improved dramatically by the Whole Foods, Plant-Based diet, more so than by any drug known to man:
ALS,
Dementia,
Stroke,
Depression,
Skin Appearance,
Ear Infections,
Periodontal disease,
Acid Reflux,
Laryngeal cancer,
Lung disease,
Breast cancer,
Heart disease,
Obesity,
Hypertension,
Diabetes,
Inflammation,
Colon cancer,
Constipation,
Lower back pain,
Sexual Function,
Osteoporosis,
Athletic performance,
Arthritis

In other words, what else do you need to know? Well maybe the following table, comparing the level of nutrition that you get on a plant-based diet versus an animal foods based diet.

The differences are laughable:
                                           Plant-based versus Animal-Based
                                           (Nutrition per 500 cal consumed)   

Cholesterol (mg)                0                             137
Fat (g)                                4                              36
Protein (mcg)                    33                            34
Beta-carotene (mcg)         29,919                     17
Dietary  fiber (g)               31                            0
Vitamin C (mg)                 293                           4
Folate (mcg)                     1168                         19
Iron (mg)                          20                             2
Magnesium (mg)              548                           51
Calcium (mg)                   545                           252

As I said: What else do you need to know?

Dr. Ostfeld also made mention that the results from the #WFPB diet for diabetics are 3x better than from a standard ADA (American Diabetes Association) diet, as documented recently by Dr. Neal Barnard in the new release of his book, Dr. Barnard's Program for Reversing Diabetes.

Yet Another #WFPB Supper at Packsun

This week we had another lovely #WFPB Supper at Packsun...

Simple and sumptuous.

Three veggie dishes and GABA Brown Basmati rice

The dishes were simple:

A lentil stew with poi leaf (Malabar Spinach) with onions, garlic, turmeric, cardamom, bay leaf and chilis, be sure to add some black pepper because it potentiates turmeric, and you can use some Braggs Liquid Aminos in lieu of salt to finish it to taste.

A side of cauliflower with onions, garlic and turmeric.

Khokon and father David before digging in, I was taking the picture

And another side dish with broccoli, onions, garlic, turmeric and cardamom.

Khokon is also starting to eat more plant-based food and has lost weight that way. Father David estimated his weight loss in the first 6 months was about 80 lbs and 8" on his belt size, and the whole parish is noticing that he looks so much better. I keep joking with him that he will run the marathon yet.

The most important ingredient in any successful meal according to Khokon: put your heart into it.

On Friday of this same week my cardiologist (Dr. Robert Ostfeld of the Montefiore Cardiac Wellness Program) fired me: "I wish all my patients did so well!"

The #WFPB Nutrition Paradigm Shift Is Under Way in the Bronx

On Friday October 27th, I attended the first annual Montefiore Preventive Cardiology Conference, which was an amazing experience.

Many of the heavyweights in the field were there, and it was a truly amazing experience. While the material was meaty, since the conference offers educational credits for medical professionals, it was accessible to the general public as well, and people had come from all over the country. There was even a delegation from the Brooklyn Borough President's office, as well as from the Mayor's office, in this week when it had just been announced that Brooklyn was launching Meatless Mondays in 15 public schools.

The speakers included the following:

• Opening remarks by Dr. Robert Ostfeld, cardiologist at Montefiore, who was the conference organizer.
• He was followed by Dr. Paul M. Ridker, Director of the Center for Cardiovascular Disease Prevention at the Brigham and Women's Hospital, who spoke on the issue of inflammation in cardiovascular disease. The bottom line is that cholesterol levels and inflammation are equally important in cardiovascular disease (CVD).
• Next came Dr. Neal Barnard (he of PCRM fame), who spoke on the role of nutrition in the prevention and treatment of diabetes. The bottom line is that the ADA approach (low carb), does not work nearly as well as a Whole Foods Plant-Based diet without added sugar, oil or salt, and that this is now fully scientifically proven. It is notable that fruit is healthy for diabetics because the sugar in the context of fruit is not a problem, it's the refined sugar we add to food that is the problem. Carbs are also essential, and sugar in and of itself does not cause diabetes, fat does. So, the avoidance of added oils and fats is critical. Most importantly, once a patient starts on the diet, the changes can happen so fast that medical supervision is critical since otherwise people can become hypoglycemic if their medications are not adjusted in a timely fashion. Not in all cases, but for probably two thirds of diabetics it seems realistically possible to get off of medicine and insulin altogether within weeks or months.
  Dr. Barnard's graphical illustrations of the diabetes mechanism were extremely helpful.
  Barnard also brought up a fascinating report on Geico, where he was involved in lowering health care costs with a Whole Foods Plant Based diet, for a company that is self-insured for health. This type of development could point the way towards a better solution for our healthcare crisis. Whole Foods operates along similar lines.
• Next was Dr. Kim Williams of Rush University Medical Center in Chicago and former president of the American College of Cardiology, who spoke on "Describing My Evolution Toward Advocating for a Lifestyle Oriented Approach for the Prevention and Treatment of Cardiovascular Disease. A very engaging speech - you can get a little taste here.
• Next up was Dr. Caldwell Esselstyn, Jr. and it is always a delight to hear him state his core position, that heart disease is a toothless paper tiger that does not even exist, not to mention how amazing it is that this has become a multi-billion dollar medical specialty in the Western world, without anybody wondering why large parts of the world do not even have this problem. In short, coronary heart disease is entirely preventable and in most cases (except when it is totally critical) reversible with diet and exercise.
• Finally, Dr. Robert Ostfeld spoke specifically on the challenges of the Bronx, the borough that steadily always comes in at #62 of 62 counties in NY in the Robert Woods Johnson survey of health outcomes for the state. With his customary sense of humor he described the challenges of working in a poor community and focusing on teaching people to make the transition to a WFPB diet on a budget.
• Next, there was a panel discussion, which also included Dr. Michelle McMacken, Assistant Professor of Medicine at NYU School of Medicine and Director of the Adult Weight Management Program at Bellevue Hospital.

One of the more hilarious moments of the day (and there were many) was in the presentation by Dr. Kim Williams about a study where the relationship of dietary intake to premature death from heart disease was analyzed. At first it seemed the study indicated that red meat was worse than eggs, until it became clear that consumption of eggs causes cancer, and the patients in the study died from cancer before they died from heart disease. Conclusion: eggs are the incredible, edible carcinogen.

Another salient point that came out during the day was the difference between a "vegan" diet, defined in the negative (no animal products), but not observing the whole foods paradigm, which often produces worse health outcomes than a meat-based diet. This confirms again that "vegan" is not a useful category from a nutritional standpoint, for a whole foods plant-based diet, without added Sugar, Oil and Salt is really the issue. Potato chips, Coca Cola and chocolate may make a "vegan" diet, they do not add up to a healthy lifestyle.

Overall, it is increasingly clear that the Whole Foods, Plant-Based nutritional model is slowly becoming main stream and in fact that the adoption is picking up speed as evidenced by the developments in Brooklyn, which now are getting the support from the mayor's office, as well as the adoption in hospitals, such as the Montefiore health system, which includes five hospitals. Both AMA and the American College of Cardiology now recommend that hospitals offer plant-based menu options at every meal.

Throughout the day the food was excellent and a worthwhile demonstration of the variations that are possible within the #WFPB paradigm. The sky is the limit. Literally - as was also emphasized by various speakers - #WFPB is more bulky but you lose weight automatically and end up returning to a homeostatic, healthy weight. Overeating is never a problem because the diet is rich in fiber and nutritionally abundant as long as people eat enough different foods. There is no such thing as a protein deficiency if people eat a reasonably varied plant-based diet, and likewise the notion of supplements is completely moot, with the sole exception of B12. It was not discussed in detail, but there was mention of the fact that supplements from bottles can indeed easily be counter productive - everything is more easily absorbed from food, and the plant based diet will provide abundant nutrients.

Another simple way of looking at the problem is this: your body produces all the cholesterol it really needs, you need no dietary cholesterol ever. Plant-based nutrition has zero cholesterol and all animal-based nutrition has cholesterol, hence you should not eat it. 

As to added sugar, oil and salt: 

• sugar is harmless in fruit, but adding refined sugar in any form is bad news
• added oil is always bad, it damages the endothelium immediately, preventing your bloodvessels from dilating normally with exercise. You'll get about 10% of your calories from naturally occurring oil if you include small amounts of nuts, avocado or coconut in your diet, but, generally speaking, all plants contain small amounts of oil naturally, so it is easy to go over.
• as to salt, 2,000 micro grams per day is all you need which is easy to meet if you eat all plants, and sometimes you can even add a sprinkle, but generally you want to use herbs and spices for seasoning, not salt. All vegetables and grains contain sodium naturally.

Meanwhile, it is clear that different doctors have slightly different attitudes in practice, but they all focus on helping patients with at least a half-day of intensive nutrition counseling that includes the significant other, in order to help people get on track about their diet and stay on track. In Dr. Ostfeld's program at the Montefiore Cardiac Wellness program, this is typically a half-day program on a Saturday, that includes food so people leave inspired about the many options that exist within the plant-based paradigm.

Ostfeld tends to be rather mild and focuses on not letting the perfect get in the way of the merely good: progress is progress. The other side of that coin is that, as reported above, a sloppy and only nominally "vegan" diet is really counter productive, and in practice is often the reason why would-be vegans fail. Esselstyn typically does not allow his patients any wiggle room for that reason, for he knows that once you are on the right track, you will feel so much better, you will not want to get off it. One thing sums up the difference perhaps. Esselstyn recommends 6 fist-sized green leafies per day, typically cooked kale with balsamic vinegar, which taken together is great for nitrous oxide production. Ostfeld, more modestly, ask for four. Personally I find that cooked kale, drizzled with balsamic vinegar is an absolute delight, and I miss it when I don't have it.

Post Script:
In other news, the movie Code Blue is being announced, which is going to be a next chapter in the adoption of the Plant-based nutritional program in clinical practice. It reminds us of the fact that 86% of our healthcare spending is on treating the degenerative chronic diseases, which by and large are the result of bad diet and conversely are preventable and most often reversible with a Whole Foods Plant-Based diet. If we can eliminate 75% of the 86%, we will have largely solved the healthcare crisis. In this conference only heart disease and diabetes were being discussed at length, though the more general application was mentioned. The movie Code Blue is going to add MS to the discussion. The implications are truly staggering.

The #WFPB Nutritional Paradigm

#WFPB, the Whole Foods, Plant-Based diet as developed on the basis of The China Study, and the clinical work of cardiologist Caldwell Esselstyn, Jr is a completely new paradigm of nutrition and health. The best known introduction these days is the documentary Forks over Knives.

Veganism is usually defined in the negative, as in: no animal protein, and some vegans do not even eat honey, because it is animal based. Motivations for veganism are sometimes environmental, or based on concerns over animal welfare, and sometimes vaguely based on health concerns. Yet, if you look around in restaurants and on food labels, "vegan" is a meaningless term, because it lacks any positive assertive nutritional concept behind it.
Perhaps the most famous proponent of veganism is Israeli activist Gary Yourovsky:

Gary Yourofsky at City College of NY

The #WFPB Paradigm

#WFPB (the Whole Foods Plant-Based diet) on the other hand is a completely new paradigm for nutrition and health. The fundamental tenets could be defined as follows:

• Focus on the quality, not the quantity of protein intake.
• Healthy protein sources are plant-based, unhealthy protein sources are animal based, be it meat, fish, fowl or dairy.
• By substituting plant-based proteins for animal proteins, you also lower your overall calories from protein to a healthy 5-15% and increase your fiber intake, which is often unhealthy under an omnivore diet.
• Use whole foods, and do not use added oils or sugar.
• "Dieting" does not exist in #WFPB, because whole foods, plant-based nutrition speeds up the metabolism and people automatically achieve a homeostatic, healthy weight.
• Nutritional supplements are meaningless for #WFPB is Nutritionally complete: the only possible exceptions are some moderate supplementation of B12 and maybe vitamin D.

The fundamental research for the #WFPB lifestyle is The China Study, which was just published in a new, updated 2017 edition, by T. Colin Campbell, Ph.D. and his son Tom Campbell, MD. The clinical work that matches up to the China Study came primarily from Caldwell Esselstyn, Jr., M.D., a cardiologist from the Cleveland Clinic in Ohio, which was first published in his book, Prevent and Reverse Heart Disease. many other doctors work in the same vein. Here in the Bronx, we have Robert Ostfeld, M.D. a cardiologist at Montefiore Hospital, who runs the Montefiore Cardiac Wellness program.

T. Colin Campbell, Ph.D. on #WFPB

Nutritionally complete: the Omega-3, B12,D-vitamin

The key concept is that for all practical purposes #WFPB is nutritionally complete, if you eat a reasonably balanced range of plant-based foods.

Omega-3

A lot is often made of the difficulty to get a favorable Omega-3 to Omega-6 balance in vegan nutriton, this is a fallacy. Here are some of the sources of Omega-3 for vegans:
flaxseed, chia seed, hemp seed, mustard seed, seaweed, beans, winter squash to broccoli, cauliflower, and brussels sprouts, leafy greens, cabbage, berries, wild rice, various herbs and spices, mangoes, honeydew melon.

B12 vitamin

The only vitamin vegans generally need to supplement is B12. and that's all.

D vitamin

Supplementation of D vitamin is another issue, but that is more generic to the whole population, not just vegans. Here is a great article on vegan sources of vitamin D (note that vitamin D3 is the easiest to absorb form), and if you do not get enough sun, you may need a little vitamin D supplementation.

Beware of vegan marketing hype

Nutritional advice for vegans is usually useless if you follow #WFPB, for if your intake is reasonably varied. There are great vegan sources of iron, from raisins, to prunes, olives, avocado and dried apricots, to asparagus, endives, peas, acorn squash, dandelion greens, Kale, turnip greens, to lentils, chick peas, quinoa, wheat germ, brown rice, and sprouted beans or seeds, and lastly morel mushrooms, brewer's yeast, spirulina, and blackstrap molasses.

But by and large the whole notion that supplements are useful are part of the SAD legacy. In the context of the SAD paradigm, supplements may seem helpful, but this type of research is really silly and misleading, because it focuses on how single nutrients (or medications) improve health outcomes, without questioning the overall train wreck that is the Standard American Diet. Under #WFPB the notion of dietary supplements is silly. The body can generally not absorb them very well, so other than expensive urine, the benefits are limited. It is absurd to ask for small improvements amidst a perfectly preventable disaster. 

The health care angle

As a nation, we are spending 75% of our healthcare dollars on treating degenerative illnesses that can generally be reversed with better nutrition, specifically #WFPB. We spend more on healthcare than any other nation, but without results, for our health statistics remain bad. Here is a brilliant presentation by T. Colin Campbell that sums it all up.

These days the Physicians Committee for Responsible Medicine (PCRM) practically has become the standard bearer for the role of nutrition in medicine. And things are picking up speed at a remarkable rate. Here is some of the latest:

• They just finished up hosting the Fifth-Annual International Conference on Nutrition in Medicine, and one of the fruits of it was an impressive YouTube video about 700 doctors advocating for Prevention over Pills - a ringing endorsement of the #WFPB lifestyle.
• They reported on a recent article by Russel Simmons on refocusing the SNAP program on healthy foods, because the poor have such bad health outcomes already. It is truly criminal to use a government program to provide people more junk food that makes them ill.
• Dr. Neal Barnard's latest book, The Cheese Trap, makes the brilliant case of the correlation of our obesity crisis with the growing cheese consumption, and why cheese is literally addictive (there is a weak opioid in milk that becomes concentrated in cheese). The book also sheds light on government complicity with the dairy industry.
• PCRM came out petitioning the USDA to modify the MyPlate nutritional recommendation and to ditch dairy, and swap animal protein for legumes.
• The American College of Cardiology urges hospitals to add plant-based meals and eliminate processed meats.
• The AMA passed a resolution: Hospitals should provide plant-based meals and remove cancer-causing processed meats.
• The AMA calls for healthier foods in the SNAP program.

This list is evidence of the impressive progress PCRM is making, and they are only just getting started. They truly stand on the shoulders of giants, for it is the work of T. Colin Campbell and his associates in The China Study which is the foundation of all the further research in this area. There is also an excellent documentary on the health issue, What the Health.

Eat your heart out, dieters

The upshot is that the #WFPB lifestyle is actually easier and cheaper than the alternative - meat is surprisingly expensive. Going to a #WFPB will cost you some money in the change over. You may want some different kitchen appliances, and your pantry needs restocking, but you can do that gradually over time, though some folks need to do it all at once, lest they fool themselves and hang on to old, bad habits, such as added oils or sugar.
But since plant-based nutrition speeds up your metabolism, there is no dieting under this concept. Eat to your heart's content, as long as it is reasonably varied, and your body will automatically return to a homeostatic, optimal weight, without even having to think about it.
In short, indulge, you are eating your way to health, as long as you stay within the #WFPB paradigm.

Cardiac Wellness Program at Montefiore

Patients come in and cry over the progress they are making with a Whole Foods Plant-Based Diet; nobody ever cries tears of joy over a Lipitor prescription.
                                                   Robert J. Ostfeld, MD. MSc.

I just spent my Saturday morning with Dr. Robert Ostfeld, Director of the Cardiac Wellness Program at Montefiore and Lauren Graf, nutritionist to the program. This was a half-day workshop intended for cardiology patients and their significant others, which they teach numerous times during the year. The purpose evidently is to help people adopt their new no-oil Whole Foods Plant-Based (WFPB) lifestyle, and helping the process by involving their household. The general tenet of the program is that, the whole foods plant- based diet of Dr. Esselstyn and T. Coin Campbell, Ph.D. is the way to go and except for in severe cases, a small amount of oil in the form of oil-rich fruit, e.g. nuts, avocado, etc., is healthy, but that it is mostly the added oils that cause harm, so you want to avoid added oils in all forms.


There were perhaps 30-40 people in attendance, and the workshop was both practical, and deeply informative, showing the scientific foundations of the dietary approach/ life style that is being taught in this program, as much as hands-on dietary recommendations. There was a nice lunch catered by Tastee Vegan. Check out their site. They have catered among others for Mike Tyson, who is vegan now too! The meal was an absolutely delicious sampling of vegan dishes, with lots of inspiration for stuff you could try at home.

Good for what ails you

Being that Dr. Ostfeld is a cardiologist, that is his primary focus, but the WFPB lifestyle is about more than that - it is about the whole new nutritional paradigm of eating Whole Foods, and stopping the fallacy that you can make it up with supplements: Whole foods are in, expensive urine is out. Even supplements of vitamin B12 and vitamin D are needed only sporadically and in small amonts, not necessarily every day.
Good for what ails you is the motto here, and besides the massive improvements in heart health that Dr. Ostfeld routinely sees with the WFPB diet, he produced a chart with a list of other health outcomes that are positively impacted by the adoption of a WFPB diet, which - with a little tongue in cheek - he calls the kale scan.

The Kale Scan

Just in case you have trouble reading the slide, here is the list:

• ALS
• Dementia
• Stroke
• Depression
• Skin Appearance (acne is a nutritional deficiency)
• Ear infections
• Periodontal Disease
• Acid Reflux
• Laryngeal Cancer
• Lung Disease
• Breast Cancer
• Heart Disease
• Obesity
• Hypertension
• Diabetes
• Inflammation
• Colon Cancer and Constipation
• Lower Back Pain
• Sexual Function (ED is the canary in the coal mine for CVD - Cardio Vascular Disease)
• Osteoporosis
• Athletic Performance
• Arthritis

 The bottom line is that all or most degenerative diseases that make up 75% of our healthcare spending are preventable and often reversible with a Whole Foods Plant-Based diet.

• This is obviously an area where half-measures are not much help, although Dr. Ostfeld is willing to work with people in steps.
• Added oils of any kind will collapse your veins for upto six hours after the intake, which in practice means you should avoid them at all cost, and all oils and fats are equally bad for heart health.
• At the supermarket, read the label, not the claims on the front of the box. 
• Avoid most sweeteners, including sugar, with the possible exception of Stevia, or some blackstrap molasses.
• Juice is not generally a good idea - getting the sugar without the pulp is a bad idea, while on the other hand eating whole fruits is not a risk factor with Type 2 Diabetes, but instead can be a help.

 Last, not least, there were many useful discussions about foods to buy and not to buy, and mention of a cookware line that is very suitable for the WFPB lifestyle, called 360 Cookware.

What's next: 

 On Friday October 27th, 2017, there will be an all-day conference, the Montefiore Preventative Cardiology Conference (you can register at the link), that is open to the public. Speakers will include:

• Robert J. Ostfeld, MD, MSc, Host
• Paul M. Ridker MD, MPH - Beyond LDL Cholesterol: Does Inflammation Matter?
• Neal D. Barnard, MD - Nutrition in the prevention and Treatment of Diabetes
• Kim A. Williams, MD - Personal evolution towards lifestyle changes for prevention and treatment of CVD (CardioVascular Disease)
• Caldwell B. Esselstyn, Jr. MD - Nutritional Reversal of Coronary Artery Disease: Fact or Fiction?
• Robert j. Ostfeld, MD: The Impact of Lifestyle Change in Cardiovascular Risk Factors and the Bronx

This is a training for Cardiologists and other doctors, but it is open to members of the public. If you're not a patient of Dr. Robert Ostfeld, send your doctor! It is high time they find out.
The Bronx's #not62 program to improve health outcomes in the Bronx has not (as yet) been very successful, yet this program at Montefiore deserves to be a center piece in the strategy.

Online Resouces for a Whole Foods Plant-Based Lifestyle

There is a plethora of viable online information available today to make it easy for anyone to successfully ease into a Whole Foods Plant-Based lifestyle. I call it a lifestyle and not a diet, for as long as you shift to the new paradigm of eating only whole foods and everything plant-based, you can pretty much eat what you like and any sense of "dieting" is gone. One reason I never tried any diet seriously was because I don't like dieting, but my cooking/eating style has evolved over the years and with the arrival of the plant-based diet, cooking has become more enjoyable than ever. For whatever it is worth, all my life cooking was essentially my favorite hobby, so for me to say that has to mean something.
I went from vegetarian as a kid to omnivore in my twenties, including a macrobiotic period, an Italian period, a Japanese period, various garbage periods, and eventually drifting back towards mostly vegetarian, and vegan since May of 2015, and realistically that was primarily based on the Esselstyn information, so I like to call it "no-oil WFPB," or "oil-free WFPB."

The salient facts

• 75% of our healthcare spending is on treating degenerative diseases, such as CardioVascularDisease (CVD) - including Erectile Dysfunction (ED),  Type 2 Diabetes, High Cholesterol, High Blood Pressure, Prostate cancer, Colon cancer, macular degeneration, cataracts, arthritis, osteoporosis. See a.o. this blog on Vegan.io.
• A diet based on animal proteins is 10-20 times more resource intensive than a diet based on plant-based proteins. See this infographic on the True Environmental Cost of Eating Meat. On the whole, the environmental impact of animal husbandry is greater (18% of greenhouse gas emissions) than that of the entire transportation industry (13% of greenhouse gas emissions).
• In short, by switching to a WFPB diet, you are becoming healthier yourself, you are making a huge contribution to the environment, and you are helping to feed the world: four billion people could be fed from what is now "feed grain," for cattle.

Online support for the WFPB diet

Here are some of the online resources that can help you.

• Physicians Committee for Responsible Medicine - tons of information, including the invaluable (and free) 21-day kickstarter program.
• Engine2 7-day Rescue Challenge. This free program offers an easy way to get started on a #WFPB (Plant Strong) diet, or a refresher, if you feel stuck in your cooking. Brilliant stuff from Rip Esselstyn and Engine2.
• Food Revolution Network - unbelievable amounts of information, almost too much. Pricey, but offers great handholding.
• Plant-based on a budget - my kind of site, free or cheap.
• T. Colin Campbell Center for Nutrition Studies - A wealth of information from one of the leading sources.
• Dr. Caldwell Esselstyn, Jr.'s Prevent & Reverse Heart Disease program - Again, one of the leading sources.
• Engine2 Plant Strong - Rip Esselstyn, Dr. Esselstyn's son, offers his own variation, based on his experiences with his fire fighter colleagues.
• Plant-based medical providers. and more here - it helps if your physician understands your diet, for the whole paradigm is different if you seriously try to follow the WFPB. Whole Foods Plant-Based diet.
• Cardiac Wellness Program - Montefiore Hospital, Bronx, NY - every patient of Dr. Robert Ostfeld, cardiologist at Montefiore is invited to his half-day nutritional seminar with their significant other, to learn the practice of the vegan (WFPB) lifestyle on a budget.
• American College of Lifestyle Medicine - A professional association for Lifestyle Medicine. You can also find medical providers in your area who subscribe to the Lifestyle Medicine concept.

We want to be very conscious of the fact that WFPB is gaining traction in the medical community and presently both the AMA and the American College of Cardiology are urging hospitals to offer vegan meal options at all times. The AMA is urging to take cured meats off the menu as they are carcinogenic, and additionally, it is also urging the government to focus SNAP benefits on healthy food choices.

Vegan Videos

There are videos, there are many powerful documentaries that have helped lots of people, some are found on Youtube, some have their own sites:

1.  The Mad Cowboy. Howard Lyman, former cattle rancher turned vegan, is at the center of this absolutely classic documentary which followed on from Lyman's appearance on Oprah, and the lawsuit by the Texas Cattlemen that tried to stop Lyman's message that beef was not as healthy as they say it is. Howard's book and the documentary "Mad Cowboy"followed.
2. Forks over Knives. The most important documentary on the work of T. Colin Campbell, Ph.D. and Dr. Caldwell Esselstyn about the new nutritional paradigm of the Whole Foods Plant-Based diet, based on the results of the China Study, and Esselstyn's clinical work. The message is: 75% of our healthcare dollars go to the treatment of degenerative diseases that can usually be prevented and often reversed by switching to a Whole Foods Plant-Based diet.
3. Cowspriracy puts it all together from an environmental angle as well. Very powerful.
4. What the Health. The follow-on project from the makers of Cowspiracy, which explores the connection to how medicine and bad diet go hand in hand.
5. Talk by Howard Lyman, has the whole story of the lawsuit, and lots of useful information.
6. Meat the Truth, another useful documentary that puts together the environmental angle.
7. Dairy is Dangerous, by Dr. Neal Barnard. Powerful story by Dr. Neal Barnard, president of Physicians Committee for Responsible Medicine, (PCRM). His latest book, The Cheese Trap is also highly recommended.
8. The Perils of Dairy, Another excellent production on the perils of dairy by Dr. John McDougall.
9. Best Speech You Will Ever Hear by Gary Yourovsky. An incredibly powerful presentation on the benefits of the Whole Foods Plant-Based diet from Israeli activist Gary Yourovsky. He is now retired from 'activism,' but his contributions stand the test of time.
10. Animal Protein Causes Cancer. This is a very powerful recap of the main findings of T. Colin Campbell on how animal protein causes cancer, and plant protein turns it off. No more needs to be said.